The present invention relates, in general, to an automated system of electronic communications between a health-care or medical service provider and his/her patient, for the purpose of providing a simple, reliable and effective interface for rapidly exchanging inquiries, responses, data, services and information between the both parties for the mutual benefit and satisfaction of each.
Health care used to be simple and reliable. When symptoms of an illness appeared, either the doctor visited the patient""s home or the patient went to the doctor""s office. But such services no longer exist. Home care by doctors stopped decades ago, and even visits to the doctor""s office or hospital must now be preceded by authorization from a managed health care provider. Under certain conditions, care may now be refused entirely unless payment is made in advance. Consequently, consumers have, by necessity, become more active in managing their own health, and they worry about how much they must spend on health-care services.
Meanwhile, health-care providers are now under more pressure than ever to treat a greater number of patients in the same amount of time, but with diminishing resources. The pressure began in the 1980""s with the advent of managed health care and the associated reduction in physician compensation in the face of an inflated economy. This trend continued through the 1990""s, but was exacerbated by patient demands for an increased voice in their care, better access to the doctor and more information about their medical situation. As a result of cost cutting, merging and reengineering, doctors have been left with the dilemma of either reducing service to their patients or increasing capacity. The effect has been a mutual disenfranchisement of both doctors and patients. This is evidenced by the increasing number of doctors, who are now leaving medicine to pursue other careers, and by the fact that the ones remaining are considering resorting to labor unions to protect their interests.
A number of commercial entities have attempted to assist doctors by creating xe2x80x9cback-officexe2x80x9d operations and management solutions. Back office solutions are defined as those processes applied to the current day-to-day management of a doctor""s practice (i.e., eligibility, claims, on-line practice management, etc.). However, they do not address the doctor""s relationship with the patient. Unfortunately, implementation of a back-office service has a high impact on the practice, because it requires a significant addition of resources and necessitates system and process modifications in the doctor""s office, including substantial training of staff, integration and work process changes. Therefore, the back-office approach is tied to what have proven to be insurmountable problems involving additional time, cost and management expenditures for the practice.
Companies that sell in-house systems for the back-office space, include medical record vendors, such as Medicalogic and Epic, as well as practice office management vendors (POMS), such as IDX. Recently, such vendors have been redeveloping their burdensome back-office solutions to deliver them on-line and compete in the space currently occupied by Healtheon/WebMD. Nevertheless, whether delivered on-line or in-house, each of these solutions has a high impact on the operation of the doctor""s office, and as a result will face significant hurdles before they can be adopted regardless of cost, delivery method or the like.
At the same time we now live in an age of information and technology. The Internet provides a number of services to its users, including the World Wide Web (WWW), which is essentially a collection of files, often referred to as Web pages, in a variety of formats stored on host computers, often called Web servers. A collection of Web pages published by an organization is typically termed a Web site, wherein its first or highest level page is termed a xe2x80x9chomepage.xe2x80x9d Consequently, Internet technology has spawned a health-care industry online to provide health-care information to both patients and professionals, and for any number of reasons, individuals are turning to the Internet with increasing frequency for expertise regarding diseases, medicines, treatments, alternative health products, and even the selection of doctors.
To provide greater access to the Internet the communication protocols and languages utilized by users and servers have become standardized. These protocols include (i) the Hyper-Text Transfer Protocol (HTTP), which is an application-level protocol for distributed, collaborative, hypermedia information systems, and the communication protocol used for communications between users and servers, and (ii) the Transfer Control Protocol/Internet Protocol (TCP/IP), wherein the TCP portion is the standard Internet transport specific protocol (or set of protocols) for communication and data exchange between computers or applications. TCP/IP handles issues such as packetization, packet addressing, handshaking and error correction. Also standardized is the language in which users (the patient or consumer seeking information) and servers (the information service providers) communicate, which is called the Hyper-Text Markup Language (HTML).
Although most Web pages are textual documents described in HTML, the pages may also include images, still or moving, and audio data. The key feature of HTML is the ability to define Hypertext Links within the document, which provide access points to other parts of the same document, other Web pages or other Internet facilities.
To access the World Wide Web, the user employs software on his/her computer known as a Web xe2x80x9cbrowser.xe2x80x9d Commercially available browsers include, for example, Netscape Navigator(trademark) and Microsoft Internet Explorer(trademark). The browser provides an interface, a local cache, and a set of processes for accessing the Internet, navigating over the myriad sites, communicating with a selected site, including E-mail, error detection and correction, and security facilities.
HTTP messages consist of either requests from user to server or responses from server to user. The user enters the address (Uniform Resource Locator (URL)) of a Web page into his/her browser, or selects one from a list of previously stored addresses, often referred to as Bookmarks. The URL is a descriptor that specifically defines a type of Internet resource and its location, i.e., the address of the Web server holding that Web page, which has an address beginning xe2x80x9cHTTP://xe2x80x9d. Access to most Web pages is unrestricted; however, it is possible for access to be controlled by the use of passwords and security restrictions
After the Web page address is entered, the Web browser automatically contacts the user""s service provider, dialing up a link over the telephone network if necessary, and issues a request for that Web page. The Web browser then sends an HTTP request to the Web server, which responds to the HTTP request by sending the requested HTTP object to the user. In most cases, the HTTP object is a plain text (ASCII) document that is written in HTML language, which the Web browser displays on the user""s computer screen. The HTML document contains all of the information needed by the browser for displaying a Web page on the user""s computer. Typically, the document contains xe2x80x9chyperlinksxe2x80x9d that the user can click; doing so causes the Web browser to send a request to the Web server for one or more additional documents. The part of the link displayed to the user is generally distinguished from other parts of the page, for example text may be underlined or in a different color.
Generally the user""s computer relies upon a mouse (or trackball) and an on-screen pointer for inputting commands. For example, the pointer is often arranged to change shape or color when located over a hypertext link. When the user selects a hypertext link, usually by positioning the pointer over it and clicking a mouse button, the Web Browser software automatically accesses the corresponding Web page.
The Web browser also evaluates the HTML data to determine if there are any embedded hyper-link statements, which would require subsequent browser requests, which would then be initiated by the browser. The functions of browsers and server software, examples of HTML-coded documents, and the use of links and similar HTTP protocol constructs are described by, e.g., Judson, U.S. Pat. No. 5,572,643, issued in 1996.
Thus, the Internet has become a convenient and powerful tool for many consumers seeking information about a variety of topics, including healthcare, particularly as it becomes increasingly difficult to get service from medical personnel. However, reliance on the Internet for such crucial information could prove hazardous to a patient""s health. While there are many legitimate and valuable consumer health portals and health-care sites on-line, such as drKoop.com, Intellihealth.com and AmericasDoctor.com, as well as those by recognized groups, such as the American Diabetes Association, medical professionals, government officials and consumer advocates have recently expressed grave concerns that information from such reputable sites might be misunderstood by consumers. Moreover, less than reputable sites exist that have misled patients by making deceptive claims of miracle cures and bogus breakthroughs.
Patients have, however, expressed concerns and reservations because the information on the Internet is not delivered from xe2x80x9ca trusted source,xe2x80x9d so that even after hours of searching, the patient may not be sure that he has gotten the xe2x80x9crightxe2x80x9d information. Given the option, patients still consider their personal physician to be the most reliable source of health-care information. Consequently, it is not unusual for the patient to collect a wealth of information from the Internet, and then take it to his/her doctor for validation, which either the doctor will refuse to do, or which will exacerbate the doctor""s ever increasing time constraints. Therefore, even in this age of information there remains a significant need for effective and reliable communication between patients and their doctors, so that (i) the patient is not left to rely on information of unknown accuracy from arbitrary service providers on the Internet, (ii), trust in medical practitioners and service to the patient can be restored, and (iii) billing, scheduling and administrative functions are efficiently facilitated for both parties. Moreover, there remains a need in society for restoring communications between doctors and their patients, for enhancing service to patients, and for expanding the capacity of the medical practice, without additional work by the doctor or his/her staff.
Recognizing the endemic and chronic lack of adequate communication between health-care providers and their patients, the present invention provides a communication system for providing automated, electronic communications between at least one health-care provider and a plurality of users of the health-care provider, wherein the communications occur over a communications network through a provider/patient interface, said system comprising:
a central server, comprising one server or a logical unit of multiple servers;
a provider""s service computer,
a plurality of users"" computers; and
a communication network for enabling communication between and among the central server, the provider""s service computer, and the plurality of users"" computers. In a preferred embodiment, the communication system of the present invention is the first Electronic Provider-Patient Interface (the ePPi(trademark)). The preferred users of the ePPi system are patients, and the preferred provider is the patient""s own doctor or health-care practitioner (xe2x80x9cthe practicexe2x80x9d).
The ePPi system addresses one of the patient""s primary concernsxe2x80x94access to information and services from their own doctor. The ePPi system, provides an automated service to patients, through which access to their own doctor is provided over the Internet without additional work for the doctor""s office because it is based upon existing records. Prior to this invention, patients were frustrated by their inability to gain access to their doctors, while doctors were equally frustrated because there simply was not enough time for them to provide the service they would have liked to their patients. Health-care providers realized that they had to find a way to increase capacity without sacrificing quality, service or patient access; but without increasing cost. The ePPi system offers an automated and efficient provider-patient communication system that resolves both the patient""s and the provider""s aggravation by providing appropriate health-care information and services.
At the core of the present invention is a fully automated mechanism for generating a personalized area (patient pages) for each patient within the doctor""s or health-care group""s Web site in the ePPi system. Custom mappings are established in the ePPi system between the practice""s common visit codes, diagnoses codes and procedure codes, thereby permitting automatic delivery of content to the patient through the logic of the system. Thus, the patient""s page is created without extra work or effort by the practice through an automated process that uses the data that has already been entered into the practitioner""s scheduling and billing systems. As a result, once the patient has logged into his/her own Web page, he/she can also access a variety of practice-based services including, appointment requests and updates, prescription refills, online triage, health search information and the like.
Based upon the previously entered content from the practice about the patient, and the coded information added to the system following each additional visit, diagnosis or procedure in the patient""s history (all of which contribute to determining the content of the patient""s page), visit-specific content is made available on-line to the patient after a visit to the practice. This offers the patient significantly more information than he/she could have absorbed during a typical visit with the physician. Patient inquiries or requests regarding episodic events, such as appointment and prescription refill requests, can be submitted at the convenience of the patient, and can then be handled by the doctor""s staff much more efficiently; both in terms of time and flexibility, than ever before possible.
Moreover, the ePPi system is a powerful patient relationship management tool in the doctor""s front-office practice. Patients can become increasingly involved in their own care, and less dependent on physician office resources. For the medical practice, this translates into reduced cost, increased capacity and increased customer satisfaction. For the patients, the effect is not only enhanced savings and satisfaction, but the on-line information is now available from their own doctors, rather than from unreliable sources on the Internet. In addition, the system captures unique data that is of significant interest to researchers and suppliers of health-care products, which can be utilized to affect patient behavior (e.g., compliance), product development and marketing, on-line sales and advertisement.
The ePPi implementation collectively embodies a set of one or more server computers, which perform various tasks. These computers may or may not necessarily be co-located in a single facility. Regardless of their physical location, they comprise a logical unit, working in concert to provide the ePPi functionality. The functional components provided in the communication system of the present invention include:
a Web server capable of responding to HTTP requests from users by sending HTML formatted documents to those users;
a database server capable of maintaining complex relationships between practices, patients, doctors, and healthcare informational content;
a modular data collection program that receives information from doctors"" or practitioners"" scheduling and billing systems regarding patient visits, in a variety of different data and file formats, reformats the information, and stores it in the database;
an electronic mailing capability which supports the automated transmission of notifications to patients when new information is added to the database, as well as the transmission of notifications to practice-designated personnel whenever new requests from patients are made (e.g., appointment scheduling requests, prescription renewal requests, non-urgent questions for a doctor, etc.).
The communication system of the present invention provides a system, wherein there are one or more providers, each of which is in communication with a plurality of users. Additional component servers can be added to the system as new functionality is introduced or additional capacity is needed. Furthermore, the architecture has been designed with maximum flexibility in mind, so that the ePPi Service Center may be scaled appropriately to the needs of the users. Thus, it may be required to have more Web servers and fewer database servers, or more database servers and fewer Web servers. A single computer could host only one functional component, or a combination.
As the system and database are updated, refined or modified, additional features will be introduced. For example, the present invention further offers the ability to evaluate prescribed medications, in the event that a particular drug is not available, or that an equivalent generic drug may cost substantially less. Nevertheless, the system will remain unique to each individual client since criteria that are of interest to one patient may be of no interest to another. In the preferred embodiment of the present invention, the server uses a hypertext transfer protocol (xe2x80x9cHTTPxe2x80x9d) to communicate over the network with either providers or users; such providers and users also communicate with the server using the hypertext transfer protocol. The server typically includes at least one server processor, a memory and a computer readable medium, such as a magnetic (xe2x80x9chard diskxe2x80x9d) or optical mass storage device, and the computer readable medium of the server contains computer program instructions for transmitting the file from the server system to the providersxe2x80x3 or user""s system and for transmitting static or dynamic objects to the provider""s or user""s system, respectively. The provider or user typically will utilize a processor and a memory and a computer readable medium, such as a magnetic or optical mass storage device, and the computer readable medium of the provider or user contains the computer program instructions for receiving and storing static, dynamic or mixed objects at the provider""s or user""s computer. The static object, in a typical embodiment, will include a name attribute, such as a domain attribute.
The present invention further provides a communication system, wherein the communication network is either an Internet or intranet network. The preferred communication network is the Internet.
The preferred communication system of the present invention comprises a provider-patient interface Service Center, wherein custom content is dynamically assembled and delivered. Moreover, delivery in the preferred system occurs over the World Wide Web, and custom content is preferably assembled using Active Server Pages (ASP) technology. Custom content is preferably selected from a library of information, and the selection is based upon specific data received from the provider about each user, who is served by the provider. The data about each user comprises information about each user""s visits to the provider. Further, the custom content selection in the preferred communications system is based upon logical mappings that reside in the relational database server.
The present invention also provides a communication system comprising a unique provider""s Web site for each of the one or more providers, wherein each Web site is supported by or in communication with the central server through the Service Center. Moreover in the preferred communication system, the provider/patient interface provides a fully automated mechanism for generating a personalized page or area within the provider""s Web site for each user serviced by the one or more providers, and the provider""s Web site is in communication with at least one user""s computer through the provider/patient interface. In certain preferred embodiments of the communication system, at least one provider""s Web site and at least one user""s computer are hyperlinked through the provider/patient interface.
In the preferred communication system of the present invention computer system, submissions of information from one or more providers and from the users of the electronic communications system are in standardized formats. Moreover, the standardized formats are preferably derived from standard administrative and billing codes used by the provider.
The present invention further provides a method of automatically and electronically communicating between at least one health-care provider and a plurality of users serviced by the health-care provider, wherein the communication occurs over an electronic communication network through a provider/patient interface, wherein the method comprises (i) a communication is initiated from one of the plurality of users to his/her provider for information; (ii) the communication is transported through the provider/patient interface over an electronic communication network to a site which is unique to the provider on a central server; whereupon the communication is automatically reformatted and processed or stored; (iii) the communication is electronically compared with mapped content, which has been previously provided by the practice to the central server, to formulate a response as a static or dynamic object, or a combined static and dynamic object; and (iv) the communication is automatically returned, along with the requested information, to the user""s computer, whereupon the communication and information are read by the user or stored on the user""s computer. Moreover, when the user""s communication includes a communication or inquiry regarding additional information or an episodic event, the method further comprises the additional step of notifying the provider and the user automatically that a response or information has been sent to the user""s computer.
The preferred embodiment of the method of the present invention is implemented by the electronic provider-patient interface system (the xe2x80x9cePPi systemxe2x80x9d).
In the method of the present invention, the central server comprises: a Web server capable of responding to HTTP requests; a database server capable of maintaining complex relationships between users and information content; and a modular data collection program capable of receiving information as coded data from practices in a variety of different formats, and reformatting and storing the information. The central server may further comprise an electronic mailing capability to support the automated transmission of notifications to users or providers.
In addition, in the method of the present invention, there are one or more providers, each of which is in communication with a plurality of users.
In the method of the present invention, the communication network is either an Internet or intranet network. The preferred communication network is the Internet.
The preferred method of the present invention comprises a provider-patient interface Service Center, wherein custom content is dynamically assembled and delivered. Moreover, delivery in the preferred method occurs over the World Wide Web, and custom content is assembled using Active Server Pages (ASP) technology. Custom content is preferably selected from a library of information, and the selection is based upon specific data received from the provider about each user, who is served by the provider. The data about each user comprises information about each user""s visits to the provider. Further, the custom content selection in the preferred method is based upon logical mappings that reside in the relational database server.
The present invention also provides a method comprising a unique provider""s Web site for each of the one or more providers, wherein each Web site is supported by or in communication with the central server through the Service Center. Moreover, in the preferred method the provider/patient interface provides a fully automated mechanism for generating a personalized page or area within the provider""s Web site for each user serviced by the one or more providers, and the provider""s Web site is in communication with at least one user""s computer through the provider/patient interface. Also, in certain preferred embodiments of the method, at least one provider""s Web site and at least one user""s computer are hyperlinked through the provider/patient interface.
In the preferred method of the present invention computer system, submissions of information from one or more providers and from the users of the electronic communications system are in standardized formats. Moreover, the standardized formats are preferably derived from standard administrative and billing codes used by the provider. The information delivery by the preferred method is in HTML format.
In yet another preferred method of the present invention automatic and electronic communication is made possible between and among at least one health-care provider and a plurality of users serviced by the health-care provider, wherein the communication occurs over an electronic communication network through a provider/patient interface. The method comprises the following steps: (i) a notification or communication is initiated from a provider to one of the plurality of users serviced by that provider; (ii) the notification or communication is transported through the provider/patient interface over an electronic communication network to a site which is unique to the provider on a central server, whereupon the notification or communication is automatically reformatted and processed or stored; (iii) the notification or communication is electronically compared with mapped content, which has been previously provided by the practice to the central server, to automatically formulate the notification or communication to include such additional objects or information as may be assigned by the mapped content; (iv) the notification or communication is automatically forwarded to the user""s computer, whereupon the notification or communication is read by the user or stored on the user""s computer; and (v) the provider and the user are both automatically notified that the notification or communication has been sent to the user""s computer.
One embodiment of the present invention provides an on-line appointment system. A user can browse the information provided by the provider""s Web site on the central server, preferably on his/her own patient page. The user can then request information, such as an appointment for a selected time and date, and for a particular doctor in the practice. The server then sends static information related to the appointment to the browser on the user""s computer for storage, along with automatic notification to the provider and the user that information has been sent. When the user wants to confirm the appointment, the browser sends the corresponding static information to the practitioner""s specified Web page for processing.
Another embodiment of the present invention provides an on-line information service, wherein information regarding a variety of topics, such as a particular symptom or disease, is provided either in response to an inquiry from the user or as available data in the provider""s site on the Web server. The user may browse through the various pieces or types of information by making HTTP requests from the provider""s Web site on the central server. As stated above, the patient has the security of knowing that the information is accurate since it is provided on-line by his/her own doctor, rather from an arbitrary and unknown source on the Internet.
These and other features of the present invention will be disclosed in the following description of the invention together with the accompanying figures.